Humana Faces Lawsuit
On Matters of Coverage

Two well-known law firms joined forces to sue Humana Inc., alleging that the company deliberately misleads patients about the criteria it uses to make coverage and treatment decisions.

The lawsuit, which seeks class-action status, seeks to compel the Louisville, Ky., managed-care company to disclose to plan members that it relies heavily on cost factors rather than just medical necessity in coverage and other decisions. For example, the suit alleges Humana uses an elaborate set of financial incentives designed to hold...